City Rescue Mission Dental Clinic

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CITY RESCUE MISSION DENTAL CLINIC

Practice address

800 W California Ave
Oklahoma City, OK 73106-7807

Phone

(405) 232-2709

Fax

(405) 236-0341

NPI assigned

May 1, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Debra McCullock, ARNP

Title

Clinic Director

Phone

(405) 232-2709

Specialties & licenses 1

Addresses

Tax ID family

City Rescue Mission Dental Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• City Rescue Mission Medical Clinic

  • Community Health Clinic/Center
  • Oklahoma City, OK
  • NPI 1194944272
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239753600000",
    "number": "1093936924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W CALIFORNIA AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731067807",
            "telephone_number": "405-232-2709",
            "fax_number": "405-236-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W CALIFORNIA AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731067807",
            "telephone_number": "405-232-2709",
            "fax_number": "405-236-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY RESCUE MISSION DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2009-04-15",
        "status": "A",
        "authorized_official_last_name": "MCCULLOCK",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "405-232-2709",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steve Garcia Cisneros
• City Anesthesiology PC
• City of Goshen Health Services LLC (Coghs)
• City of Oklahoma City
• City Psychiatric PC
• City Rescue Mission Medical Clinic
• City Wide Physical Therapy LLC
• Claborn Eyecare LLC
• Lasha Kay Claborn
• Melanie K Claborn, PHARM.D.

• Dentist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.